Sleep Apnoea Explained | Sleep Matters Club

Reviewed for Medical Accuracy by Dr Jason Ellis

What is sleep apnoea?

Sleep apnoea is a common sleep disorder where people repeatedly stop breathing throughout the night, this is due to the muscles in your throat collapsing or lack of signals your brain sends to keep you breathing at night. Sleep apnoea is a widespread condition that affects a large population of the UK, so much so, that many sufferers are not aware that they even have this condition. To help you understand what it is and help you recognise it, here we define sleep apnoea symptoms. And explain what causes sleep apnoea and talk about how to treat it.

What are the 3 types of sleep apnoea?

There are three types of sleep apnoea, ‘Central Sleep Apnoea’ (CSA), ‘Obstructive Sleep Apnoea’ (OSA) and ‘Complex Sleep Apnoea Syndrome’.

Obstructive sleep apnoea

Obstructive sleep apnoea affects roughly 1.5 million people in the UK according to the NHS and British Lung Foundation. This type of disorder occurs when the walls of the throat relax and narrow during deeper sleep stages either creating a brief total cessation of breathing (an apnoea) or partial cessation (hypopnea). This often results in loud snoring or gasping strong enough to wake you up, although this brief awakening may not be recalled

Central sleep apnoea

Central sleep apnoea is the less common of the two and occurs when the brain doesn’t send the correct signals to the muscles which control our breathing.

Complex sleep apnoea

Complex sleep apnoea is a kind of sleep apnoea that describes sleep-disordered breathing when central apnoea occurs but only after they previously had obstructive apnoea. This change is due to continuous positive airway pressure (CPAP).

What are the sleep apnoea symptoms?

The common warning signs of sleep apnoea to look out for at night include:

Irregular and laboured breathing
Loud snoring or breathing
Gasping or snorting
Wake up often in the night
Occasionally, people who suffer from OSA have also reported night sweats

As the sufferer is asleep during the episode of sleep apnoea, they are often unaware there is anything wrong. In fact, the sleep study mentioned in the BBC adds that “80% of those with the condition are unaware they have it”. Often it is the partner or a family member who will notice that during their sleep they appear to be struggling to breathe normally.

What causes sleep apnoea?

The causes of this condition can be down to a number of things and certain people are more likely to be affected by obstructive sleep apnoea. The most common causes and risk factors that the NHS suggests are:

Being overweight. Excess fat and soft tissue in the neck can place strain on the muscles which lead to difficulty breathing.
Nasal congestion. If the tissue between your nostrils is slightly bent, this could lead to difficulty breathing.
Menopause. Women are more likely to suffer from OSA after menopause as the neck and throat muscles can loosen due to hormones.
Being over 40. While OSA can occur at any age, those over 40 years old are at increased risk.
Being male. Due to a difference in body fat distribution, males are at increased risk.
Drinking alcohol before bed or smoking. This can make snoring and in turn, OSA worse.
The size of your neck. People with larger necks are more likely to suffer due to strain on the muscles.
Sedatives have often been linked to OSA.
A family history of OSA. Inherited genes can increase the chance of sleep apnoea.

Women is yawning in front of laptop wearing white headphones.

The effects of sleep apnoea

When there is an episode of OSA the sufferer is woken with a start as the body’s adrenalin response kicks in to restart the breathing and clear the airways. The outcome of this is that the person often spends most of the time in lighter sleep or being woken. This can leave the sufferers of this medical condition, and their partners, with excessive tiredness during the daytime.

Such sleep deprivation also can have a significant effect on many different areas of life including physical health, weight, and mental health. For example, it has often been linked to depression and memory loss. The NHS has also shown that those who suffer from sleep apnoea may be up to 12 times more likely to be in a car accident because of fatigue, which is why it’s compulsory to inform the DVLA if you suffer from this condition.

How to treat sleep apnoea

If you suspect that you may be suffering from sleep apnoea then you should speak to your GP. They may refer you for a simple sleep study. This will involve going to sleep at home while wearing a finger probe which can monitor the sleep apnoea episodes you have per hour. If you have 5-15 episodes in an hour, you’re considered to have mild sleep apnoea. 15-30 episodes per hour would be classified as moderate and over 30 events per hour are severe sleep apnoea, which needs immediate treatment.

The first step to managing obstructive sleep apnoea OSA is to adjust your lifestyle. Simple cuts such as lessening your alcohol intake, losing excess weight, and quitting smoking should show improvements. If you take tablets to help you sleep, try and cut these out as well, with the support of your GP, as sedatives are linked to making this condition worse.

After this, the first line of treatment is Continuous Positive Airway Pressure therapy or a CPAP device for short. This sleep apnoea machine works to gently provide a constant stream of positive air pressure through the airways via a mask. At first, this can feel strange but many people find they get used to the mask quickly and benefit from much deeper and more refreshing sleep as a result.

Other options for less severe forms of OSA include a device called a Mandibular Advancement Device (MAD) which acts like a gum shield and helps by moving the jaw forward to leave more space for the airways by tightening the muscles around the throat. In a minority of extreme cases, surgery may be helpful if the cause of your sleep apnoea is an unusual neck structure.

What happens when sleep apnoea is left untreated?

Although the idea of stopping breathing in your sleep can sound terrifying, our bodies are designed to wake us up so that we take another breath. If left untreated, the effects of sleep apnoea, and consequently sleep deprivation, could lead to high blood pressure, an irregular heartbeat and even a stroke or heart attack. In fact, an April 2019 study from the University of Iowa found a link between sleep apnoea and multiple myeloma, a type of deadly blood cancer. To sum up, untreated severe sleep apnoea can increase the risk of heart disease or death by two-thirds according to sleep studies.

Sleep apnoea and diabetes

It’s a commonly asked question whether sleep apnoea can lead to diabetes. According to Diabetes.co.uk, numerous studies have linked obstructive sleep apnoea with the risk of developing type 2 diabetes. This is because sleep apnoea affects the concentration of oxygen within the bloodstream, but is also thought to be due to obesity which is commonly developed with this sleeping disorder. Further, the poor sleep associated with OSA has also been linked to type 2 diabetes.

How to help sleep apnoea

If this condition is getting you or your partner down, there are some tips you can follow to help with sleep apnoea.

1. First of all, try sleeping on your side. This makes it a little more difficult for your tongue or your soft tissues to disrupt your airways and, therefore, makes you less likely to snore.

2. Try sleeping with your head elevated and add another pillow. According to Very Well Health, some people have decreased sleep apnoea if they have the head of their bed slightly elevated. In such cases, an adjustable bed might be useful in keeping the head elevated while you snooze.

3. Finally, Helpguide.org suggests a few throat exercises you could try to strengthen the muscles in the airway and lessen the symptoms of sleep apnoea. These include: Press the length of your tongue to the roof of your mouth and hold it for up to three minutes a day.

It may take a few weeks before you notice any improvements. Gargle water for around five minutes, twice a day. And hold your tongue between your teeth and swallow five times. Repeat this five times per day.

If you’re concerned you have sleep apnoea seek your doctor’s advice for the specific treatment best for you.